社区医院与三级医院治疗小儿肱骨髁上骨折的成本分析。
Cost Analysis of Treating Pediatric Supracondylar Humerus Fractures in Community Hospitals Compared With a Tertiary Care Hospital.
机构信息
From the Department of Orthopaedics, University of Maryland School of Medicine (Dr. Shasti, Case, Dr. Hariharan, Dr. Jauregui, and Dr. Abzug), and Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine (Dr. Li), Baltimore, MD.
出版信息
J Am Acad Orthop Surg. 2020 May 1;28(9):377-382. doi: 10.5435/JAAOS-D-18-00585.
OBJECTIVE
In the current healthcare environment, providing cost-efficient care is of paramount importance. One emerging strategy is to use community hospitals (CHs) rather than tertiary care hospitals (TCHs) for some procedures. This study assesses the costs of performing closed reduction percutaneous pinning (CRPP) of pediatric supracondylar humerus fractures (SCHFs) at a CH compared with a TCH.
METHODS
A retrospective review of 133 consecutive SCHFs treated with CRPP at a CH versus a TCH over a 6-year period was performed. Total encounter and subcategorized costs were compared between the procedures done at a CH versus those done at a TCH.
RESULTS
Performing CRPP for a SCHF at a CH compared with a TCH saved 44% in costs (P < 0.001). Cost reduction of 51% was attributable to operating room costs, 19% to anesthesia-related costs, 16% to imaging-related costs, and 7% to supplies.
DISCUSSION
Performing CRPP for a SCHF at a CH compared with a TCH results in a 44% decrease in direct cost, driven largely by surgical, anesthesia, and radiology-related savings.
目的
在当前的医疗环境下，提供具有成本效益的医疗服务至关重要。一种新兴策略是将社区医院（CHs）用于某些手术，而非三级保健医院（TCHs）。本研究评估了在 CH 进行小儿肱骨髁上骨折（SCHFs）闭合复位经皮克氏针固定术（CRPP）的成本与在 TCH 进行该手术的成本。
方法
回顾性分析了在 CH 与 TCH 进行 CRPP 治疗的 133 例连续 SCHFs，比较了在 CH 与 TCH 进行的手术的总费用和分类费用。
结果
与 TCH 相比，在 CH 进行 CRPP 治疗 SCHF 可节省 44%的费用（P < 0.001）。运营成本降低了 51%，麻醉相关成本降低了 19%，影像学相关成本降低了 16%，耗材成本降低了 7%。
讨论
与 TCH 相比，在 CH 进行 CRPP 治疗 SCHF 可降低 44%的直接成本，主要归因于手术、麻醉和影像学相关的节省。
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